Case Presentation from Oxford

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Case Presentation from Oxford

• Integrated Childrens Low Vision Conference Oxford

Rasmeet Chadha Deputy Head of
Optometry Oxford Eye Hospital
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Ophthalmic Case History

• Female DOB 04.02.03 (Oxford)
• Diagnosed with bilateral congenital cataracts and
  microphthalmos
• Seen at GOSH age 17 days
• Cataract surgery within 6w of diagnosis
• Post surgery fitted with contact lenses at GOSH
• Ongoing Ophthalmic care transferred to Oxford Eye
  Hospital.
• Possible cortical visual impairment

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Medical Management
Genetics.Oxford, Cardiff, Bham
In patient. Eczema and poor weight gain
Dermatology
Audiology
Community Paediatrics
Age 0-3 years
Cranio Facial Service (CF)
Opthalmology GOSH OEH
Physiotherapy
Endocrinology
Neurology
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HEPAC
Assessment centre for children with multiple
disabilities

• Paediatrician
• Physiotherapist
• OT SLT
• Dentist
• Clinical Pyschologist
• Orthoptist Ophthalmologist
• Social Worker

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Co-ordinated Working Across Medical Specialities

• Facilitated by
• HEPAC CF service
• Personal contacts
• Letters in notes from medical and non medical
  providers
• Parent

• Hindered by
• Segregated patient notes
• Missing referral letters
• Lack of awareness of all service providers
• No clear key worker

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Low Vision Services
Providers of Low Vision Services
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Non Medical Provision
Visual Impairment Team/ QTVI
Social and Community Services
Nursery
Pre School Teacher Counselling Service
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Nursery

• Concerns regarding Contact Lenses and swimming
• Teaching session at OEH for Nursery teachers

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Co-ordinated Working in Providing Low Vision Care

• Termly Interagency meeting
• Individual case discussion
• Should attendance be extended?

• Low Vision Services Committee
• Personal contacts

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Communication

• The key to successful multidisciplinary working

• Poor communication may exacerbate problems of
  efficiency of care and at the very least cause
  confusion

(Fragmented vision Survey of Low Vision Services
in the UK. Ryan B, Culham L. 1999) )
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Methods of Communication

• Non office based work
• Email, fax, phone, letter
• Confidentiality
• A system that works in your area

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What Do We Do?

• QTVI send annual reports or interim reports.
  Improving links with Social and Community
  Services
• LVA reports to parents, other service providers,
  schools
• Email addresses
• Departmental secretary (telephone access)
• The future EPR, a possibility for greater
  sharing of information

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Summary

• Children with Visual Impairment require
  multidisciplinary Low Vision Services
• In presence of additional disabilities
  collaboration between all services is essential
• Communication is the key to providing seamless
  care

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Thank you